A 36-year-old male is bitten by the snake shown in the image. Which of the following symptoms is the patient most likely to experience?

A 45-year-old woman with no past medical history presents after an acute exposure to chlorine gas at a public swimming pool. She complains of shortness of breath and has diffuse expiratory wheezes. She is mildly tachypneic and has a heart rate of 109 bpm. She complains that her eyes are minimally irritated. What should her care include?

Emergency medicine physicians have a very high risk of chemical dependence. Healthcare professionals in general also have a high recovery rate. Why is the recovery rate so high?

Within the disease of chemical dependence, what is the principal symptom displayed by impaired medical professionals?

A 65-year-old male with an unknown medical history is brought in by ambulance with altered mental status after being found unconscious in his parked car on a hot summer day. You note that he appears very dry and his skin is warm to the touch. His initial vital signs include a blood pressure of 105/75, heart rate of 122, respiratory rate of 24, and oxygen saturation of 96%. A rectal temperature is obtained and measures 40.5 degrees Celsius. What is the most rapid method of cooling this patient?

Which of the following is NOT a U.S. Food and Drug Administration (FDA) approved indication for hyperbaric oxygen?

Which of the following treatments is most helpful in a patient who presents 12 hours after a prolonged deep sea dive with knee pain and a headache?

A nearby nuclear power plant incurs an explosion sending a significant amount of gamma radiation into the nearby community. Multiple patients present to your emergency department with concern for radiation poisoning. Which of the following patients is most critical?

A 53-year-old man with a past medical history of a liver transplant presents to the emergency department after being told his immunosuppressant level is high. His labs show a tacrolimus level of 27 ng/mL (reference range 5-20 ng/mL). What is the most common, clinically significant adverse effect of tacrolimus?

A 45-year-old Pennsylvanian man presents after receiving a snake bite to his right hand. He notes that the snake was brown and had a triangular head. He presents with pain and swelling of his right 2nd and 3rd fingers, as well as numbness to the area. On examination, there are ecchymosis visible on the right hand with difficulty extending and flexing his 2nd and 3rd digits due to the swelling. A CBC is significant for a platelet count of 45 x 109/L. What is the next appropriate treatment for the patient’s condition?

A 35-year-old male with a history of migraines presents to the emergency department because of the acute onset of uncontrolled head-turning to one side, ipsilateral shoulder elevation, and tongue protrusion. He was previously discharged from an emergency department the night prior after being treated for a migraine headache. He has no other medical problems and takes no medications at home. The patient’s vitals are pertinent for tachycardia but otherwise unremarkable. He appears anxious and his head is turned at 55 degrees to the left with facial grimacing. His left shoulder is elevated, and his tongue is protruding from his mouth. He is unable to voluntarily move his head or shoulder. The rest of his examination is unremarkable. What is the best treatment for this patient?

You are on a busy overnight shift and are handed the following ECG for a patient who was just brought in by ambulance. What is the most likely diagnosis?

Paramedics arrive at the site of a factory explosion. On site they come across a patient who has a piece of machinery fragment stuck in his right thigh. The bleeding is controlled, and the patient’s right lower extremity has normal pulses, strength, and sensation. His injury is an example of what type of blast injury?

A patient with suspected chloroquine-resistant malaria is being treated with intravenous quinidine sulfate, doxycycline, and boluses of normal saline. The patient has a sudden change in orientation and is now diaphoretic and tachycardic. What is the most appropriate treatment in this patient?

In a patient presenting with cocaine-induced hypertension, which blood pressure agent should be avoided?

Which of the following patients is at greatest risk for exertional heat stroke?

A 24-year-old male suffers a high-voltage electrical injury to the right upper extremity. In which of the following scenarios does the patient require surgical decompression?

Which of the following is not recommended for the prevention of acute mountain sickness?

Four workers arrive by ambulance after a chemical plant leak. After appropriate decontamination efforts, the patients are assessed in the emergency department. They have tearing eyes, rhinorrhea, and mild coughing. They also complain of throat pain. Which of the following is most likely to be responsible?

A 36-year-old male from Texas presents to your emergency department with a one day history of severe diffuse abdominal pain. He also endorses two days of diffuse muscle aches and muscle spasms. He recalls being bit by an insect two days previously, but cannot recall what it looked like. His vital signs demonstrate a temperature of 98.5 degrees Fahrenheit, a heart rate of 105, a blood pressure of 165/96, and an oxygen saturation of 99%. His physical exam is significant for a diffusely tender abdomen with voluntary guarding and some rigidity. He has no significant erythema or rashes on his skin. What is the next best step in management?

23-year-old female is sent to the emergency department (ED) from hematology-oncology clinic for dystonia. She was receiving a highly emetogenic chemotherapy treatment for hepatic sarcoma and was sent to the ED because the nurse noted that her neck became hyperextended. Of the following medications, which drug is the most likely cause of her symptoms?

Which of the following indicates a poor response to acclimation after three months at high altitude?

A 45-year-old male with a past medical history of schizophrenia and bipolar disorder presents one hour after ingesting a gallon of household bleach. Which of the following is true regarding caustic ingestions?

Which of the following tissues best conducts electricity?

A 36-year-old female has a dislocated shoulder. You choose to use propofol and fentanyl for procedural sedation. After administration of the drugs, the patient’s eyes are closed, she is breathing spontaneously, has good oxygen saturations, a blood pressure of 110/70, and heart rate of 85. She slowly answers yes/no questions only and grabs your hand with her non-injured hand when light sternal rub is applied. What level of sedation has been produced?

A 45-year-old woman with a history of benzodiazepine dependence presents to your emergency department (ED) after an intentional ingestion of diazepam one hour prior to arrival. The patient endorses consuming 50 diazepam 10 mg tablets after getting into an argument with her husband. While in the ED she becomes more lethargic and her breathing becomes shallow. What is the best course of action?

A 22-year-old female is diagnosed with new onset schizophrenia, for which she was started on haloperidol treatment. Which movement disorder, if present, will be a delayed complication of therapy initiation or dose change and is potentially irreversible?

There is an explosion at a local grocery store. You are told there are hundreds of people who are potentially injured and you are first to the scene. You start using the Simple Triage and Rapid Treatment (START) technique. The first person you examine is a young female lying on the ground with a palpable radial pulse - heart rate 120, respiratory rate 27, mild facial trauma, and an obvious open right lower extremity deformity. She is alert but does not follow commands. Which color tag is appropriate for triaging this patient?

Which of the following is true regarding electrical injuries?

A 52-year-old male is fulfilling his bucket list wish to climb Mount Everest. He has just arrived at basecamp (altitude 5,545 meters) and is planning to spend several days acclimating to the increased altitude. Within the first day of arrival, he starts feeling unwell and experiences all of the symptoms listed below. Which of these symptoms is an indication for immediate descent?

A recreational diver goes for a two-hour dive at 100 meters. While beginning his ascent, the patient sees a shark and resurfaces too quickly. Which of the following is an example of decompression sickness?

A 19-year-old male presents with altered mental status. His vitals are as follows: Temperature 106.7⁰F, heart rate 168, blood pressure 112/78, respiratory rate 18, oxygen saturation 99%. His ECG shows atrial fibrillation with rapid ventricular response. What treatment should be initiated immediately?